Intractable upper gastrointestinal ulceration due to aspirin in patients who have undergone surgery for peptic ulcer Basil I. Hirschowitz, Angel Lanas

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Presentation transcript:

Intractable upper gastrointestinal ulceration due to aspirin in patients who have undergone surgery for peptic ulcer Basil I. Hirschowitz, Angel Lanas Gastroenterology Volume 114, Issue 5, Pages 883-892 (May 1998) DOI: 10.1016/S0016-5085(98)70307-5 Copyright © 1998 American Gastroenterological Association Terms and Conditions

Fig. 1 Serum salicylate concentrations measured after ≥12-hour fast in patients who presented with a recurrent ulcer after surgery for peptic ulcer. In each case the data are presented separately for those who gave a positive history of aspirin use (Pos, 1–4 g/day; ○) and for those who denied using aspirin (Deny; ●). Gastroenterology 1998 114, 883-892DOI: (10.1016/S0016-5085(98)70307-5) Copyright © 1998 American Gastroenterological Association Terms and Conditions

Fig. 2 (A) Basal and (B) maximal acid output (pentagastrin stimulated) after each of the three operations. (C) Fasting serum gastrin concentration. Gastroenterology 1998 114, 883-892DOI: (10.1016/S0016-5085(98)70307-5) Copyright © 1998 American Gastroenterological Association Terms and Conditions

Fig. 3 (A) Jejunal ulcer in a 40-year-old woman 9 years after Billroth II anastomosis. Aspirin level, 15.8 mg/100 mL; basal and maximal acid outputs, 0 mEq/h; fasting serum gastrin concentration, 54 pg/mL; tests for H. pylori, negative. (B) Jejunal ulcer in a 45-year-old man 2 years after Billroth II and Roux-en-Y anastomosis. Aspirin, 6.4 mg/100 mL; fasting gastrin, 69 pg/mL; H. pylori, negative. (C) Barium radiograph in the same patient showing stomal stenosis 6 months later. (D–E) Two duodenal ulcers in a 71-year-old woman 3 months after vagotomy and pyloroplasty. Basal acid output, 4.4 mEq/h, maximal acid output, 15 mEq/h; H. pylori, negative. (F) Gastric ulcer in a 44-year-old man 8 months after vagotomy and pyloroplasty. Aspirin history, 8–10 tablets/day; basal acid output, 3.4 mEq/h; maximal acid output, 34 mEq/h; H. pylori, negative. Gastroenterology 1998 114, 883-892DOI: (10.1016/S0016-5085(98)70307-5) Copyright © 1998 American Gastroenterological Association Terms and Conditions